The human-centered health system: transforming healthcare with design

Report of the WISH Design in Healthcare Forum 2018

27 Oct 2018

Executive Summary

The field of design spans an array of professional disciplines – from architecture to human factors to visual design – but is underpinned by two core practices: empathy and prototyping. Empathy involves seeing the world through the eyes of the people involved – a patient, clinician, caregiver or other important system stakeholder – to gain a deep understanding of their needs. Prototyping involves rapid iteration processes, which incorporate user feedback to ultimately arrive at a flexible solution. These practices are the foundation of person-centered design and underpin the three categories of design most applicable to healthcare:

• Professional design

Skilled designers with varied expertise work together in teams to create a user-centered experience

• Co-design

The practice of partnering with patients in design activities, so that the patient becomes an active part of the design team

• Design thinking

A structured approach for people who do not identify as designers to focus on their users, gain insight from a completely different perspective and address insights with creativity.

Healthcare providers and policymakers can employ these tools to design a human-centered health system, ensuring that people are the focal point of all care solutions. Human-centered, or patient-centered, care is increasingly viewed as an essential element of high-quality care. This model results in engaged patients and carers, leading to greater satisfaction, outcomes, and efficient resource allocation.

This report sets out a plan of action, supported by successful case examples, for healthcare leaders to embed design principles to support a human-centered health system.

Make a visible commitment to human-centeredness

Incorporate the experiences and insights of patients, citizens and the workforce in policymaking, design activities, process improvement, and innovation initiatives. All projects which result in a service experience or health outcome for a patient should involve input from both patients and providers.

1. Mandate empathic design research activities. A common pitfall in innovation initiatives is to rush to the development stage as quickly as possible. A central tenet of the Double Diamond process (see Figure 3), and design in general, is to ensure that sufficient time is spent in the discovery stage. Starting with empathic methods for understanding the needs of the people involved will increase the effectiveness and impact of the ultimate solution.

2. Involve and incentivize patients and the public. Throughout the design process, there are continuous opportunities to engage with patients, care providers and members of the public. Their insight and contributions must be valued at the same level as other subject matter experts.

3. Partner with patients to co-design. In harnessing the increasing level of sophistication of healthcare consumers, we must proactively create partnerships with patients and citizens and actively support grassroots movements such as Nightscout, #WeAreNotWaiting, E-patients and D-patients. Teach design thinking principles to every staff member All health system workers should receive exposure and training in two essential practices of design: empathy and prototyping.

4. Mandate empathic design research and prototyping training for accredited healthcare professionals. All healthcare professionals should be trained to recognize the value of human-centered design. Professionals should have a basic understanding of the core concepts of design and be exposed to a portfolio of human-centered design initiatives. Widespread adoption of design thinking can lead to a transformation of problem solving throughout the sector.

5. Incorporate human-centered design training for the entire workforce. In shaping a successful human-centered health system, ideas and inspiration can come from a variety of sources. Training programs should include all members of staff and could include practical exercises such as partnering with quality improvement and innovation teams.

6. Facilitate bottom-up problem solving. Create opportunities for clinicians and members of the workforce to highlight problems seen on the front line and participate in design processes to solve them.

Invest in targeted design expertise

In addition to embedding design thinking within general workforce training, policymakers should consider establishing dedicated human-centered design teams.

7. Embed design teams in government and healthcare organizations. Dedicated teams build momentum for innovation initiatives through building a track record and institutional knowledge. Successful examples of such teams include the UK’s Government Digital Service (GDS), the Kaiser Permanente Innovation Team, the Design Institute for Health at Dell Medical School, and the Helix Centre embedded inside Imperial College Healthcare NHS Trust, among others.

8. Sponsor design challenges in healthcare. Declaring design challenges sets an inspiration agenda. These challenges bring together interdisciplinary teams in a focused environment or timeframe to achieve a collaborative result. Some of these initiatives can be open to the public and leverage crowdsourcing mechanisms, while other efforts can take the form of co-ordinated events that bring together teams with high focus and energy.

9. Sponsor a Community of Practice. Human-centered design is likely to be happening indistributed pockets of any healthcare organization. Connecting these efforts and magnifying their reach will bring a positive momentum that will spill across the organization and the communities being served.

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